Approaches

Specific approaches to treating children with autism

*Educational approach categories were taken from Appendix E, Interventions: Approaches and Methodologies. Please see their comprehensive website for a more detailed listing.

**Additional information was pulled from Lorna Wing’s 1976 edition of Early Childhood Autism. A full citation can be found on the Additional Resources page.

Applied Behavioral

Assumptions: Behaviorists believe that some forms of Autism involve abnormal neurological processes that cause the behavioral and emotional problems that are characteristic of autistic children. Autistic children are thought to be unable to learn in a normal environment, but with patient and logical instruction, the children will be able to increase their social functioning.

Goal: The main goal for behavioral therapists is to teach social skills to facilitate the child’s social interactions.

Methods: An instructor guiding students through different tasks step by step teaches appropriate social skills to them. Each time a child responds correctly to a step it is accompanied with a positive reinforcement.

Biological

Assumptions: Biological approaches to autism assume that some patients with the disease have some sort of neurological damage or abnormality. These intellectuals believe that pharmaceutical drugs can help to normalize some of the chemical imbalances that the neurological problems have caused.

Goal: Lewis claims that the biological approach aims to stop the repetitive behaviors often displayed by autistic children by blocking the uptake of serotonin by the central nervous system (which acts as positive reinforcement for the repetitive behavior). Thus the drugs interrupt the reinforcement chain.

Method: Medical professionals to help control some of the symptoms of autism have utilized several drugs; such as the barbiturates, amphetamines, methylphenidates, and various tranquilizers**. More information on medications.

Developmental

Assumptions: Developmental theorists believe that a child must undergo a certain sequence of experiences in order to develop “normally”. If a child experiences certain developmental problems, it may not be due solely to biology. It may be that during development the child did not go through all the necessary sequences of experience. If this is the case, developmental therapists attempt to re-connect the missing sequences in the child’s developmental process.

Goal: The aim is to help the child to feel a “normal” range of sensations, to learn to relate to other people, and to begin to use their thought processes in an organized fashion.

Method: Developmental Therapists engage in a lot of one-on-one interaction with the child. Social interaction is the focus of the treatment and the child’s pattern of interacting with parents and family members is spotlighted. Appropriate social interaction skills are taught through repeated exposure to social situations and According to Greenspan, treatment ideally involves a large team comprised of “mental health professional, speech pathologist, occupational therapist, and special educator” (1992).

Sensorimotor

Assumptions: Sensorimotor adherers believe that autistic children have difficulty engaging in normal social interactions, because they seek self-stimulating and repetitive experiences.

Goal: To engage autistic children in order to teach them to generalize appropriate social interactions, both verbal and nonverbal, in their everyday experiences.

Method: Programs that take this approach may utilize both auditory (AIT) and sensorimotor integration training. AIT is used with autistic children who display hypersensitive hearing. Sensorimotor training involves acclimating the child to positive social interactions by engaging them with physical stimuli. This might constitute a teacher swinging a child while attempting to engage them in conversation. Play with other children also allows the instructor to construct environments appropriate to the child’s social capabilities and foster continued positive development.

Making an Assessment

Treatment should be reflective of ongoing medical care and assessment accommodating one's needs, abilities, and behaviors as they change (e.g., progress or digress). Commonly practiced in the assessment of Autism are a combination of treatments requiring the use of professionals, such as physicians, educators, Psychiatrists, and Psychologists, who collaborate to ensure the possibility of providing the most efficient and beneficial treatment possible. Behavioral modification treatments used in the process of promoting education is the primary and ongoing influence in the individual's level of attainment in social, behavioral, and communication efficacy. Prior to implementation of behavior modification treatment, individuals are assessed according to functioning, abilities, and levels in the following areas of concentration: Communicative abilities, such as language acquisition, hearing and other auditory reception abilities, pronunciation, voice quality (monotone), and the ability to hold and maintain a conversation with another. Interests and unusual behaviors, for instance, restricted or preoccupied interests in specific objects with moving parts, interest interfering with functioning, and whether change of activity causes excitability. Injurious behaviors, these may become a focus of clinical treatment. Behaviors should be observed for frequency, intensity, and duration, in an environment in which the child is accustomed. Injurious behaviors may be signals exhibiting an onset of pain, or early signs of infection (e.g., face slapping as a possible indication of a need for dental treatment). Cognitive ability and response to stimuli are often assessed by observation of ones ability to engage in play and response to new materials or objects, also their reaction to stimuli and environmental change

Determining Which Approach Fits Your Child’s Needs

Autistic children are by no means cookie cutter. There is a wide range of behaviors and physical disabilities that are associated with autism. A parent must evaluate their own child’s specific needs when determining the best course for education and treatment. A teacher must likewise utilize developmentally appropriate curricula and tools for their autistic student.

The Individual Educational Plan (I.E.P.) is a good indicator of what measures need to be taken in regards to educating an autistic child. The I.E.P. is a goal oriented plan that is constructed at least annually by people like a child’s parents, teacher, and health care specialists. With the I.E.P., development can be tracked and specific issues relevant to the child can be addressed. Your child’s I.E.P. should be one of the key components in deciding which educational program is appropriate for him or her.

Most researchers agree that whichever treatment plan is implemented, it should be done so as soon as possible for the best results.

Additional Information on Medication

No medication can correct the brain structures or impaired nerve connections that seem to underlie autism. Scientists have found, however, that drugs developed to treat other disorders with similar symptoms are sometimes effective in treating the symptoms and behaviors that make it hard for people with autism to function at home, school, or work. It is important to note that none of the medications described in this section has been approved for autism by the Food and Drug Administration (FDA). The FDA is the Federal agency that authorizes the use of drugs for specific disorders.

Medications used to treat anxiety and depression are being explored as a way to relieve certain symptoms of autism. These drugs include fluoxetine (Prozac™), fluvoxamine (Luvox™), sertraline (Zoloft™), and clomipramine (Anafranil™). Some scientists believe that autism and these disorders may share a problem in the functioning of the neurotransmitter serotonin, which these medications apparently help.

One study found that about 60 percent of patients with autism who used fluoxetine became less distraught and aggressive. They became calmer and better able to handle changes in their routine or environment. However, fenfluramine, another medication that affects serotonin levels, has not proven to be helpful.

People with an anxiety disorder called obsessive-compulsive disorder (OCD), like people with autism, are plagued by repetitive actions they can't control. Based on the premise that the two disorders may be related, one NIMH research study found that clomipramine, a medication used to treat OCD, does appear to be effective in reducing obsessive, repetitive behavior in some people with autism. Children with autism who were given the medication also seemed less withdrawn, angry, and anxious. But more research needs to be done to see if the findings of this study can be repeated.

Some children with autism experience hyperactivity, the frenzied activity that is seen in people with attention deficit hyperactivity disorder (ADHD). Since stimulant drugs like Ritalin™ are helpful in treating many people with ADHD, doctors have tried them to reduce the hyperactivity sometimes seen in autism. The drugs seem to be most effective when given to higher-functioning children with autism who do not have seizures or other neurological problems.

Because many children with autism have sensory disturbances and often seem impervious to pain, scientists are also looking for medications that increase or decrease the transmission of physical sensations. Endorphins are natural painkillers produced by the body. But in certain people with autism, the endorphins seem to go too far in suppressing feeling. Scientists are exploring substances that block the effects of endorphins, to see if they can bring the sense of touch to a more normal range. Such drugs may be helpful to children who experience too little sensation. And once they can sense pain, such children could be less likely to bite themselves, bang their heads, or hurt themselves in other ways.

Chlorpromazine, theoridazine, and haloperidol have also been used. Although these powerful drugs are typically used to treat adults with severe psychiatric disorders, they are sometimes given to people with autism to temporarily reduce agitation, aggression, and repetitive behaviors. However, since major tranquilizers are powerful medications that can produce serious and sometimes permanent side effects, they should be prescribed and used with extreme caution.

Vitamin B6, taken with magnesium, is also being explored as a way to stimulate brain activity. Because vitamin B6 plays an important role in creating enzymes needed by the brain, some experts predict that large doses might foster greater brain activity in people with autism. However, clinical studies of the vitamin have been inconclusive and further study is needed.

Like drugs, vitamins change the balance of chemicals in the body and may cause unwanted side effects. For this reason, large doses of vitamins should only be given under the supervision of a doctor. This is true of all vitamins and medications.

Thank you to http://www.nimh.nih.gov/publicat/autism.cfm - aut10 for the use of this information.

Disclaimer: This site was put together by undergraduate students. The information provided is meant to be used as resource and should never be used in the place of professional services. Should you have a problem with any of the information provided on this site, please contact the site’s administrator.

12/14/03